Oxford Health NHS Foundation Trust has now conducted over 100,000 digital consultations. Throughout the pandemic digital consultations have enabled important therapy to continue while safely distancing patients and staff, and there are benefits over and above infection control.

Oliver Shipp, Oxford Health’s digital lead, says:

“Many patients are reporting good satisfaction as they avoid the cost and stress of driving and parking, and can undertake consultations at convenient times, from the comfort of their own homes. Young people using CAMHS say they are more comfortable using a familiar IT device at home than visiting an unnerving and clinical NHS building, and some new mothers appreciate accessing advice without the stress of travelling with their baby.”

Since the beginning of the first national lockdown in March, the trust has averaged 605 digital consultations per day. The average length of a consultation is 56 minutes. Around half of consultations are now undertaken remotely (digital or phone), with half face to face. Services which have embraced digital consultations include CAHMS, IAPT and dentistry, along with eating disorders, adult mental health, perinatal, early intervention in psychosis, health visiting and even physiotherapy.

Rapid response to pandemic

As a Global Digital Exemplar, Oxford Health was already trialling digital consultations prior to the pandemic and experience was gained from services such as multiple A&E locations to provide rapid assessment for people presenting at risk of suicide or self-harm; for children and families struggling to fit appointment to busy family life; and for IAPT talking therapies.

But as the coronavirus pandemic unfolded, a project the team was established in just one week in late March to provide a rapid response to the breaking Covid crisis. The team set ambitious targets to undertake 100,000 digital consultations with patients from April 2020 -March 2021, more than any trust had ever done and to develop a best practice digital consultations training package with a world-class academic partner

Time was secured for a clinical lead, patient involvement, transformation leads for each directorate, data support, and IT expertise. The team is led by the Trust’s digital lead, the GDE Programme manager Oliver Shipp. Oliver says:

“I’d like to thank everyone who has been involved in transitioning to this new way of working; from the clinicians who embraced online consultations, to the patients who have given us vital feedback, and the many teams across the Trust whose expertise and enthusiasm made it happen and continue to help develop this exciting new way of delivery care.

“They’ve embraced the new technology, breathtakingly quickly, even when it is unfamiliar and at a time of great upheaval in their work and personal lives.

“There has also been a really great team effort to support this, including directorate teams, service change, IT, information and others, all working together – entirely remotely – with speed and commitment.”

Patient experience at the forefront

While the ‘numbers’ target is now achieved well before the self-imposed deadline, the project team is keen to continue improving, especially in terms of patient experience.

“We know we are doing a lot, but we want to know how good the digital consultations are,” Oliver notes.

Patients and service users are invited to have their say on a survey Patient experience of digital consultations. The survey has eight cascading questions and will take only a few minutes to fill.

Oliver Shipp hosting the webinar on patient experience. Click to watch the recording.

On November 17 the trust’s Membership Team ran a public engagement event Health Matters: Patient experience of digital consultations, where four patients shared their experience and speakers chief nurse Marie Crofts, cognitive behavioural therapist Natasha Browne and Oliver Shipp answered questions from the audience. You can watch the recording here.

Partnership working

While patients and clinicians embracing the digital has been crucial for the success of the digital programme, Oxford Health has greatly benefited from working with world-class partners, too.

Olive Shipp explains:

“Microsoft invited Oxford Health to join its Technical Adoption Program, which is crucial in channelling staff and patient feedback into Microsoft’s development process. It allows us to early adopt of new features such as multiple screens and break-out rooms to improve online group therapy.

“Partnership with Oxford University is also critical. Through our partnership as one of only two mental health Biomedical Research Centres in the UK, we have an international service evaluation underway to develop a training tool for clinicians to further improve the quality of digital consultations.”

You can help us to develop the training tool by taking part in this survey.

The Trust is grateful for support from NHS Digital nationally through its Digital Strategy Board, and NHS England / Improvement through fortnightly support calls which share information and learning from Trusts across the region.